Personal Stroke Prevention Progress Chart

Track Your Risk Factors and Prevention Milestones

Cardiology

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Last updated: Mar 24, 2025

Patient Information

Name: _________________ Date Started: //___

Risk Factors Tracking

Blood Pressure

Date Reading Goal Met?
Target: <140/90 mmHg

Cholesterol Levels

Date Total LDL HDL Triglycerides
Targets:
  • Total Cholesterol: <200 mg/dL
  • LDL: <100 mg/dL
  • HDL: >40 mg/dL (men), >50 mg/dL (women)
  • Triglycerides: <150 mg/dL

Lifestyle Modifications

Physical Activity Log

  • Weekly Goal: 150 minutes moderate activity
  • Track minutes per day: ______________

Smoking Cessation

  • Quit Date: //___
  • Days Smoke-Free: _______

Medication Adherence

Medication Morning Evening Notes

Follow-up Appointments

Date Provider Notes

Emergency Warning Signs

  • Sudden numbness/weakness of face, arm, or leg
  • Sudden confusion/trouble speaking
  • Sudden vision problems
  • Sudden dizziness/loss of balance
  • Sudden severe headache

If you experience any warning signs, call 911 immediately.

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